Yesterday evening Dr. Molly Allen led the monthly support group for “Pet Angel Memorial Center” at 21st & Ridge, in Wichita Kansas. The group has been in existence for over six years, and provides help for persons grieving the loss of an animal companion. For more information, contact Dr. Allen, or Pet Angel, at 316-729-7070
Archive for July 29, 2011
28
Jul 2011
Medscape: “How can I help my uninsured patients get the medicines they need?”
From Medscape Pharmacists > Ask the Experts
Question:
How can I help my uninsured patients get the medicines they need?
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Response from Laura S. Lehman, PharmD Clinical Pharmacy Coordinator, Carroll Hospital Center, Westminster, Maryland |
Clinicians routinely encounter patients who are unable to afford their medications. According to the US Census Bureau, 50.7 million people (16.7%) were without some form of health insurance in 2009.[1] Even among those with insurance, a significant proportion of patients have inadequate prescription coverage. Patients either have to seek sources of assistance to pay for medications or forego treatments altogether.
Patient Assistance Programs
Clinicians can direct these patients and providers to a variety of patient assistance programs (PAPs) that serve to promote access to free or reduced cost medications. Manufacturers can be contacted directly to inquire about PAPs they offer for their products. But even more comprehensive information on medication and healthcare assistance is provided by a number of organizations that serve as a conduit to the larger realm of PAPs offered by state and local governments, nonprofit organizations, and pharmaceutical manufacturers. The organizations discussed in more detail below are accessible via the Internet and some by telephone.
Partnership for Prescription Assistance
The Partnership for Prescription Assistance (PPA)[2] was launched in 2005. PPA provides access to more than 475 public and private programs that provide over 2500 free or nearly free medications. According to their data, PPA has helped over 6 million patients obtain free or reduced cost medication. An advantage of the PPA is that it can be accessed by telephone in addition to the internet.
The PPA Internet request process is fairly straightforward. Via the Website, a patient or caregiver can enter the name(s) of the medications needed along with some basic financial information. Depending on the particular needs of the patient, PPA then directs the requester to various assistance programs that would meet those specific needs. For example, a resident in Maryland can enter duloxetine (Cymbalta®) in the drug name field, along with address and income information.
The Website then provides a download for the paper application for the Lilly Cares program along with contact information for a statewide program that assists healthcare providers or patients with completing the PAP application. The site also provides a search tool for free and information on low-cost clinics based on zip code, discount drug cards, and a variety of other healthcare resources.
For more information, see Partnership for Prescription Assistance or call 1-888-4PPA-NOW (1-888-477-2669).
NeedyMeds
NeedyMeds[3] is a nonprofit organization whose mission is “to make information about assistance programs available to low-income patients and their advocates at no cost.” Information on thousands of free or low-cost PAPs, government programs, disease management assistance resources, and clinics, is accessed via the NeedyMeds.org Website. Depending on the type of information requested, the Website may link one to a variety of resources. If one types “Pradaxa®” in the Brand Names list within the Patient Assistance Programs section, they will be linked to information on obtaining a discount drug card (Pradaxa® Savings Card) offered by Boehringer Ingelheim Pharmaceuticals, Inc.
NeedyMeds offers PAPTracker, a Web-based subscription software program that can be used by providers and clinics to expedite preparation of manufacturers’ application forms.
For more information, see NeedyMeds.
RxAssist Patient Assistance Program Center
RxAssist,[4] sponsored by AstraZeneca, is another free Web-based directory of PAPs, Medicare Part D information, and low-cost medication programs. The Website is divided into 2 sections: 1 geared for healthcare professionals, and 1 designed for patients. In either section, a drug name is searched, and results for applicable PAPs and discount programs are provided. The qualifying income levels for a given program are detailed as well. For example, a search for “Lovenox®” will give contact information for the sanofi-aventis Lovenox® Reimbursement Services and Patient Assistance Program along with the eligible income levels.
For more information, see RxAssist.
Savings Cards
Savings cards may be available to help patients afford medications by allowing eligible patients to buy certain prescription and generic medications at reduced prices. As noted above, a list of savings cards is available on the Partnership for Prescription Assistance Website.
One example is described below.
Together Rx Access® Card
The Together Rx Access® Card[5] is a savings card sponsored by over 15 pharmaceutical companies. This free card is available for patients who have no public or private prescription drug coverage, do not qualify for Medicare, and meet financial eligibility requirements. This program offers savings on over 300 common prescription medications and a range of generics. According to the Website, cardholders may save 25%-40% on prescriptions directly at the pharmacy. Participating pharmacies and a current list of included medications are available on the Website.
For more information, see Together Rx Access or call 1-800-966-0407.
Conclusion
The above resources are either hosted by pharmaceutical companies or are nonprofit programs. A host of additional Websites is available to direct patients and caregivers toward valuable free or reduced cost medication resources. However, caution is always warranted whenever sensitive patient health and financial information is relayed via the Internet.
MollyAllen |
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27
Jul 2011
Six Common Hidden Agendas That Interfere with Intimacy
6 Common Hidden Agendas that Interfere with Intimacy
By Christy Matta, MA
We all do it to some extent—tell stories, make statements or present ourselves in a particular way, in order to create an impression. We don’t come out and directly say what we want other people to think about us—for example, we may not directly say that we’re smart or that we’re not to blame for our problems, but our motive in telling a particular story or anecdote is to make the point that we are either smart or blameless.
Hidden agenda’s are a part of everyday communication, but, according to Mathew McKay and colleagues in their book Messages always trying to prove something through your anecdotes and having ulterior motives when you make points and tell stories has a serious impact on your ability to be close to the people around you.
Below are a few of the common hidden agendas identified by McKay and colleagues:
- I’m good—telling stories that highlight whatever you most value about yourself. You might highlight anything you perceive as good about yourself, including your honesty, courage, wealth, power or success. Unfortunately, overemphasizing your accomplishments and how wonderful you are can make it hard for people to get to know you.
- I’m good, but you’re not—This is telling stories and anecdotes that prove that you are good and right by showing how bad everyone else is. You’re the one who does it right, while everyone else messes it up.
- You’re good, but I’m not—Putting yourself down in comparison with others. This person finds themselves saying disparaging things about themselves, such as “you’re so clever, I’d never be able to dothat so well.” Often the hidden agenda is to have others take pity and reduce demands and expectations.
- I’m helpless, I suffer—These stories focus on misfortune and injustice. The hidden agenda here usually communicates “don’t ask me to do anything about my problems, I’m not responsible.”
- I’m fragile—Telling people about how you’ve been betrayed and wounded in the past, to keep people from telling you about uncomfortable topics.
- I’m tough—This often involves harried listings of all you have to do, overwhelming details of your current demands and expectations, with the underlying message that you work harder, longer, faster than anyone else.
Do you see yourself consistently using any of these hidden agenda’s? Do they work to get you what you need (for example help, less criticism or reduced demands from others), but at the same time interfere with your ability to connect to others? Hidden agenda’s are usually adaptive and serve a purpose, but getting stuck in them can isolate you from the important people of your life.
Photo by David Gohering, available under a Creative Commons attribution license.
MollyAllen |
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26
Jul 2011
Exercise Has Numerous Beneficial Effects on Brain Health and Cognition – Review Suggests
MollyAllen |
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25
Jul 2011
Building Your Resilience
FYI Building Your Resilience
Resilience is the process of adapting well in the face of adversity, trauma, tragedy, threats or significant sources of stress – such as family and relationship problems, serious health problems, or workplace and financial stressors. Resilience is not a trait that people either have or do not have. It involves behaviors, thoughts and actions that anyone can learn and develop. Developing your resilience is a personal journey. An approach to building resilience that works well for one person might not work for another. People use varying strategies. Some variation may reflect cultural differences. For example, an individual’s culture might have an impact on whether and how he or she connects with others and communicates feelings.
The following pointers may be helpful to consider in developing your own strategy for
building resilience.
Make connections. Good relationships with close
family members, friends or others are important.
Accepting help and support from those who
care about you and will listen to you strengthens
resilience. Some people find that being active in
civic groups, faith-based organizations or other local
groups provides social support and can help with
reclaiming hope.
Assisting others in their time of need
can also benefit the helper.
Avoid seeing crises as insurmountable problems.
You can’t change the fact that highly stressful events
happen, but you can change how you interpret and
respond to these events. Try looking beyond the
present to how future circumstances may be a little
better. Note any subtle ways in which you might
already feel somewhat better as you deal with difficult
situations.
Accept that change is a part of living. Certain goals
may no longer be attainable as a result of adverse
situations. Accepting circumstances that cannot be
changed can help you focus on circumstances that
you can alter.
Move toward your goals. Think about possible
solutions to the problems you are facing and
decide what realistic goals you want to achieve. Do
something regularly – even if it seems like a small
accomplishment – that enables you to move forward.
Focus away from tasks that seem unachievable.
Instead, ask yourself, “What’s one thing I know I can
accomplish today that helps me move in the direction
I want to go?”
Many people find it helpful to track their progress by
making a record of any accomplishment that moves
them toward their goals. It is important to spend a
moment reflecting on the fact that you are taking
action and achieving what you believe you need to do.
Take decisive actions. Act on adverse situations as
much as you can. Take decisive actions, rather than
detaching from problems and stresses and wishing
they would just go away. Being active instead of passive
helps people more effectively manage adversity.
Find positive ways to reduce stress and negative
feelings.
Following a stressful event, many people feel
they need to turn away from the negative thoughts
and feelings they are experiencing. Positive distractions
such as exercising, going to a movie or reading a book
can help renew you so you can re-focus on meeting
challenges in your life. Avoid numbing your unpleasant
feelings with alcohol or drugs.
Look for opportunities for self-discovery. People
often learn something about themselves and may
find that they have grown in some respect as a result
of their struggle with loss. Many people who have
experienced tragedies and hardship have reported
better relationships, greater sense of strength even
while feeling vulnerable, increased sense of selfworth,
a more developed spirituality and heightened
appreciation for life.
Nurture a positive view of yourself. Developing
confidence in your ability to solve problems and
trusting your instincts helps build resilience.
A Publication of the American Psychological Association
MollyAllen |
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14
Jul 2011
Post-traumatic Stress Disorder (PTSD)
OVERVIEW
Post-traumatic stress disorder (PTSD) is a serious mental illness triggered by a terrifying event such as rape or seeing action during military service. Going through a traumatic event can affect a person’s ability to cope and adjust, but with time and therapy most people can live normal lives. However in some cases the symptoms can get worse or last for months or even years. And when these trials really disturb your life, it’s time to see a therapist.
CAUSES
Situations that cause intense fear, helplessness or horror can be triggers to developing PTSD. Doctors don’t really know why some people get PTSD, but like most mental health problems, PTSD is probably caused by a mix of:
- The inherited aspects of your personality — often called your temperament
- Inherited mental health risks, like an increased risk of anxiety and depression
- The way your brain regulates the chemicals and hormones your body releases in response to stress
- Life experiences, including the amount and severity of trauma you’ve gone through since early childhood
While people of all ages can develop post-traumatic stress disorder, some things may make you more likely to develop PTSD, including:
- Experiencing intense or long-lasting trauma
- Being female
- Having been abused or neglected as a child
- Having other mental health problems, such as anxiety or depression
- Having first-degree relatives with mental health problems, including PTSD or depression
- Lacking a good support system
KINDS OF TRAUMATIC EVENTS
Sometimes called “shell shock,” “battle fatigue” or “combat stress,” PTSD is very common among those who have served in combat. The most common events leading to the development of PTSD include:
- Combat exposure
- Rape
- Childhood neglect or physical abuse
- Sexual molestation
- Physical attack
- Being threatened with a weapon
- Fire
- Mugging, robbery or assault
- Natural disaster
- Civil conflict
- Car accident
- Plane crash
- Torture
- Kidnapping
- Life-threatening medical diagnosis
- Terrorist attack
SYMPTOMS
The symptoms of Post-traumatic Stress Disorder usually start within three months of a traumatic event. However, PTSD symptoms can appear years afterwards, too. There are three types of symptoms: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal (hyper arousal).
Symptoms of intrusive memories are:
- Flashbacks or reliving the traumatic episode for minutes or even days at a time
- Upsetting dreams about the incident
Symptoms of avoidance and emotional numbing are:
- Difficulty maintaining close relationships
- Avoiding activities you once enjoyed
- Trying to avoid thinking or talking about the traumatic occurrence
- Hopelessness about the future
- Feeling emotionally numb
- Memory problems or trouble concentrating
Symptoms of anxiety and increased emotional arousal are:
- Overwhelming guilt or shame
- Self-destructive behavior, such as drinking too much
- Hearing or seeing things that aren’t there
- Irritability or anger
- Trouble sleeping
- Being easily startled or frightened
Because PTSD symptoms can come and go, it’s possible have more when things are stressful in general, or when you run into reminders of what you went through. You may hear a car backfire and relive combat experiences. Or you may see a report on the news about a rape and feel overcome by memories of your own assault.
COMPLICATIONS
There’s no doubt that PTSD can disrupt your whole life: your job, relationships and even your enjoyment of everyday activities. Having PTSD also means you could be at a higher risk of developing other mental or physical health problems, including:
- Depression
- Drug or alcohol abuse
- Eating disorders
- Suicidal thoughts and actions
- Cardiovascular disease
- Chronic pain
- Autoimmune diseases, such as rheumatoid arthritis and thyroid disease
- Musculoskeletal conditions
WHEN TO SEE A THERAPIST
After a traumatic experience, it’s normal to have a wide range of feelings and emotions; crying spells, lack of focus, fear, anxiety, sadness and changes in your sleeping or eating patterns. You might also have nightmares or be unable to stop thinking about the event. If you have any of these symptoms, it doesn’t necessarily mean you have PTSD. But if you have these thoughts and feelings for more than a month, if they’re severe, or if you’re having trouble getting your life back under control, then it’s time to talk to a health care professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
Source: Mayo Clinic
Sharon |
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